Long-segment lichen sclerosus(LS)urethral stricture is a challenge for urologists.Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty.In this retrospective stud...Long-segment lichen sclerosus(LS)urethral stricture is a challenge for urologists.Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty.In this retrospective study,we investigated the outcomes of these two procedures in patients with LS urethral stricture.Between January 2015 and December 2020,77 patients with LS urethral stricture underwent Kulkarni and Asopa procedures for urethroplasty in the Department of Urology,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(Shanghai,China).Of the 77 patients,42(54.5%)underwent the Asopa procedure and 35(45.5%)underwent the Kulkarni procedure.The overall complication rate was 34.2%in the Kulkarni group and 19.0%in the Asopa group,and no difference was observed(P=0.105).Among the complications,no statistical difference was observed in the incidence of urethral stricture recurrence(P=0.724)or glans dehiscence(P=0.246)except for postoperative meatus stenosis(P=0.020).However,the recurrence-free survival rate between the two procedures was significantly different(P=0.016).Cox survival analysis showed that antiplatelet/anticoagulant therapy use(P=0.020),diabetes(P=0.003),current/former smoking(P=0.019),coronary heart disease(P<0.001),and stricture length(P=0.028)may lead to a higher hazard ratio of complications.Even so,these two techniques can still provide acceptable results with their own advantages in the surgical treatment of LS urethral strictures.The surgical alternative should be considered comprehensively according to the patient characteristics and surgeon preferences.Moreover,our results showed that antiplatelet/anticoagulant therapy use,diabetes,coronary heart disease,current/former smoking,and stricture length may be contributing factors of complications.Therefore,patients with LS are advised to undergo early interventions for better therapeutic effects.展开更多
This study aimed to investigate the presence of human papillomavirus and Epstein-Barr virus in male lichen sclerosus patients. We extracted DNA from formalin-fixed paraffin-embedded foreskin tissue blocks of 47 male L...This study aimed to investigate the presence of human papillomavirus and Epstein-Barr virus in male lichen sclerosus patients. We extracted DNA from formalin-fixed paraffin-embedded foreskin tissue blocks of 47 male LS patients and 30 healthy men and performed real-time PCR test to detect HPV and EBV. None of the 47 LS patients and 30 healthy men had detectable HPV infection. EBV was detected in 18 LS patients （38.3%） and four healthy men （13.3%）, the difference is significant （P 〈 0.05）, Tissue blocks with significant inflammatory reaction tend to have higher EBV load. HPV has no significant relationship with LS. Male LS patients have higher EBV infection rate, but the role of EBV in the pathogenesis of LS needs further investigate.展开更多
Lichen sclerosus et atrophicus （LSA） of the male genitalia was a chronic, sclerosing, atrophic process of the glans and foreskin. penis can lead to urethral Atrophy and scarring in the stricture, acquired phimosis, ...Lichen sclerosus et atrophicus （LSA） of the male genitalia was a chronic, sclerosing, atrophic process of the glans and foreskin. penis can lead to urethral Atrophy and scarring in the stricture, acquired phimosis, even a significant reduction of physiological function. Though its prognosis is usually benign,展开更多
Objective:To study the effect of Baiban Ointment on gene expression profile of vulvar lichen sclerosus before and after treatment,and to provide theoretical basis for the early diagnosis and clinical treatment of vulv...Objective:To study the effect of Baiban Ointment on gene expression profile of vulvar lichen sclerosus before and after treatment,and to provide theoretical basis for the early diagnosis and clinical treatment of vulvar lichen sclerosus.Methods:Nine patients with vulvar lichen sclerosus diagnosed pathologically were selected as the study object,and the Baiban ointment was applied locally for 3 months.Gene chip technology was used to detect the vulva skin tissue in the same area before and after treatment,and the peripheral normal skin was used as the normal control group to analyze the change of gene expression profile.FC and P values were used as research indicators,and the standard of differential expression was FC value≥1.5,P value<0.05.The differentially expressed genes were screened,and GO analysis and KEGG database gene pathway analysis were carried out.Results:Compared with the normal control group,there were 22 differentially expressed genes in Group A before treatment,of which 21 were up-regulated and 1 was down regulated;compared with Group B before treatment,there were 23 differentially expressed genes,all of which were up regulated.The differentially expressed genes related to Baiban ointment treatment included TBK1、STAT1、ITGAM、VCAN、PRKACB、PROM1、PLAT、SERPINA1.Go analysis showed that the up-regulated differential genes were mainly concentrated in the extracellular exosome,cytosol,extracellular space,Golgi apparatus and other cellular component,using the biological process such as positive regulation of cell metabolism,signal transduction regulation,cell adhesion,etc.,to play a role in protein binding,enzyme activity regulation and other molecular functions.KEGG signaling pathway showed that the differentially expressed genes were significantly enriched in Toll like receptor signaling pathway,Nod like receptor signaling pathway and Fc RI signaling pathway,all of which were up-regulated signaling pathways.Among them,Toll like receptor signaling pathway and Nod like receptor signaling pathway are most closely related to the disease.Conclusion:Baiban ointment may play a role in regulating metabolism,inflammation and immune response by regulating the expression of related genes,affecting the signal transduction such as Toll like receptor signal pathway.The pathway and the genes screened in this study will provide a direction for the future study of this disease.展开更多
During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, exc...During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.展开更多
The recent International Consultation on Urological Disease(ICUD)panel 2010 confirmed that a urethral stricture is defined as a narrowing of the urethra consequent upon ischaemic spongiofibrosis,as distinct from sphin...The recent International Consultation on Urological Disease(ICUD)panel 2010 confirmed that a urethral stricture is defined as a narrowing of the urethra consequent upon ischaemic spongiofibrosis,as distinct from sphincter stenoses and a urethral disruption injury.Whenever possible,an anastomotic urethroplasty should be performed because of the higher success rate as compared to augmentation urethroplasty.There is some debate currently regarding the critical stricture length at which an anastomotic procedure can be used,but clearly the extent of the spongiofibrosis and individual anatomical factors(the length of the penis and urethra)are important,the limitation for this being extension of dissection beyond the peno-scrotal junction and the subsequent production of chordee.More recently,there has been interest in whether to excise and anastomose or to carry out a stricturotomy and reanastomosis using a Heineke-Miculicz technique.Augmentation urethroplasty has evolved towards the more extensive use of oral mucosa grafts as compared to penile skin flaps,as both flaps and grafts have similar efficacy and certainly the use of either dorsal or ventral positioning seems to provide comparable results.It is important that the reconstructive surgeon is well versed in the full range of available repair techniques,as no single method is suitable for all cases and will enable the management of any unexpected anatomical findings discovered intra-operatively.展开更多
Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients...Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.展开更多
基金This work was supported by the Project of Shanghai Medical Innovation and Clinical Research(No.20Y11904300)the Clinical Research Project of Shanghai Municipal Health Commission(No.202040437).
文摘Long-segment lichen sclerosus(LS)urethral stricture is a challenge for urologists.Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty.In this retrospective study,we investigated the outcomes of these two procedures in patients with LS urethral stricture.Between January 2015 and December 2020,77 patients with LS urethral stricture underwent Kulkarni and Asopa procedures for urethroplasty in the Department of Urology,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(Shanghai,China).Of the 77 patients,42(54.5%)underwent the Asopa procedure and 35(45.5%)underwent the Kulkarni procedure.The overall complication rate was 34.2%in the Kulkarni group and 19.0%in the Asopa group,and no difference was observed(P=0.105).Among the complications,no statistical difference was observed in the incidence of urethral stricture recurrence(P=0.724)or glans dehiscence(P=0.246)except for postoperative meatus stenosis(P=0.020).However,the recurrence-free survival rate between the two procedures was significantly different(P=0.016).Cox survival analysis showed that antiplatelet/anticoagulant therapy use(P=0.020),diabetes(P=0.003),current/former smoking(P=0.019),coronary heart disease(P<0.001),and stricture length(P=0.028)may lead to a higher hazard ratio of complications.Even so,these two techniques can still provide acceptable results with their own advantages in the surgical treatment of LS urethral strictures.The surgical alternative should be considered comprehensively according to the patient characteristics and surgeon preferences.Moreover,our results showed that antiplatelet/anticoagulant therapy use,diabetes,coronary heart disease,current/former smoking,and stricture length may be contributing factors of complications.Therefore,patients with LS are advised to undergo early interventions for better therapeutic effects.
文摘This study aimed to investigate the presence of human papillomavirus and Epstein-Barr virus in male lichen sclerosus patients. We extracted DNA from formalin-fixed paraffin-embedded foreskin tissue blocks of 47 male LS patients and 30 healthy men and performed real-time PCR test to detect HPV and EBV. None of the 47 LS patients and 30 healthy men had detectable HPV infection. EBV was detected in 18 LS patients （38.3%） and four healthy men （13.3%）, the difference is significant （P 〈 0.05）, Tissue blocks with significant inflammatory reaction tend to have higher EBV load. HPV has no significant relationship with LS. Male LS patients have higher EBV infection rate, but the role of EBV in the pathogenesis of LS needs further investigate.
文摘Lichen sclerosus et atrophicus （LSA） of the male genitalia was a chronic, sclerosing, atrophic process of the glans and foreskin. penis can lead to urethral Atrophy and scarring in the stricture, acquired phimosis, even a significant reduction of physiological function. Though its prognosis is usually benign,
基金Harbin Science and technology plan project(NO.2016RAXJ060)
文摘Objective:To study the effect of Baiban Ointment on gene expression profile of vulvar lichen sclerosus before and after treatment,and to provide theoretical basis for the early diagnosis and clinical treatment of vulvar lichen sclerosus.Methods:Nine patients with vulvar lichen sclerosus diagnosed pathologically were selected as the study object,and the Baiban ointment was applied locally for 3 months.Gene chip technology was used to detect the vulva skin tissue in the same area before and after treatment,and the peripheral normal skin was used as the normal control group to analyze the change of gene expression profile.FC and P values were used as research indicators,and the standard of differential expression was FC value≥1.5,P value<0.05.The differentially expressed genes were screened,and GO analysis and KEGG database gene pathway analysis were carried out.Results:Compared with the normal control group,there were 22 differentially expressed genes in Group A before treatment,of which 21 were up-regulated and 1 was down regulated;compared with Group B before treatment,there were 23 differentially expressed genes,all of which were up regulated.The differentially expressed genes related to Baiban ointment treatment included TBK1、STAT1、ITGAM、VCAN、PRKACB、PROM1、PLAT、SERPINA1.Go analysis showed that the up-regulated differential genes were mainly concentrated in the extracellular exosome,cytosol,extracellular space,Golgi apparatus and other cellular component,using the biological process such as positive regulation of cell metabolism,signal transduction regulation,cell adhesion,etc.,to play a role in protein binding,enzyme activity regulation and other molecular functions.KEGG signaling pathway showed that the differentially expressed genes were significantly enriched in Toll like receptor signaling pathway,Nod like receptor signaling pathway and Fc RI signaling pathway,all of which were up-regulated signaling pathways.Among them,Toll like receptor signaling pathway and Nod like receptor signaling pathway are most closely related to the disease.Conclusion:Baiban ointment may play a role in regulating metabolism,inflammation and immune response by regulating the expression of related genes,affecting the signal transduction such as Toll like receptor signal pathway.The pathway and the genes screened in this study will provide a direction for the future study of this disease.
文摘During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.
文摘The recent International Consultation on Urological Disease(ICUD)panel 2010 confirmed that a urethral stricture is defined as a narrowing of the urethra consequent upon ischaemic spongiofibrosis,as distinct from sphincter stenoses and a urethral disruption injury.Whenever possible,an anastomotic urethroplasty should be performed because of the higher success rate as compared to augmentation urethroplasty.There is some debate currently regarding the critical stricture length at which an anastomotic procedure can be used,but clearly the extent of the spongiofibrosis and individual anatomical factors(the length of the penis and urethra)are important,the limitation for this being extension of dissection beyond the peno-scrotal junction and the subsequent production of chordee.More recently,there has been interest in whether to excise and anastomose or to carry out a stricturotomy and reanastomosis using a Heineke-Miculicz technique.Augmentation urethroplasty has evolved towards the more extensive use of oral mucosa grafts as compared to penile skin flaps,as both flaps and grafts have similar efficacy and certainly the use of either dorsal or ventral positioning seems to provide comparable results.It is important that the reconstructive surgeon is well versed in the full range of available repair techniques,as no single method is suitable for all cases and will enable the management of any unexpected anatomical findings discovered intra-operatively.
文摘Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.
